DOI: 10.36347/sjmcr.2013.v01i03.011

Pages: 88-91

Patients with bilateral temporo-mandibularjoint(TMJ)ankylosis are always a challenge to anesthesiologist in terms of managing the airway. TMJ ankylosis is a difficult airway situation with a severely limited mouth opening. Awake fiber-optic intubation remains as a gold standard method for intubation in such cases. Blind nasal intubation, retro-grade intubation and tracheostomy are the other alternatives, but are associated with considerable morbidity. However, in all awake methods of intubation, patient cooperation is required. We are presenting a case of bilateral TMJ ankylosis with nil mouth opening in a 28 years old male who was posted for condylectomy and interpositionalarthroplasty. He had undergone operation twice and had a tracheostomy scar mark. So in this scenario the management of the airway becomes challenging and the patient was intubated successfully by awake fiberoptic intubation method and surgery continued with an uneventful recovery.